Guidance on referrals to Improving Access to Psychological Therapies

Rotherham Doncaster & South Humber NHS Foundation Trust offer NICE recommended treatments for people over the age of 18 years experiencing common mental health problems.

The IAPT Service provides a stepped care model ensuring patients receive the least intensive treatment in order to promote a reliable improvement. The IAPT Service is not suitable for people assessed with significant risks. The service is suitable for patients where the likelihood of acting out is very low and the impact would be minor, not requiring medical intervention. Examples include patients who have suicidal ideation but with no plans or intent, patients who may superficially cut or scratch but not requiring medical intervention. With regards to safeguarding issues the patients illness would, if at all, only impact very mildly on the safety or wellbeing of others.

Referrals Appropriate to Service Include

  • Mild to moderate depression.
  • Generalised Anxiety Disorder
  • Panic Disorder
  • Health Anxiety
  • Social Anxiety
  • Obsessive Compulsive Disorder (OCD)
  • Post-Traumatic Stress Disorder (PTSD)
  • Mild to Moderate Eating Disorder excluding Anorexia Nervosa
  • Adjustment Disorder

RDASH IAPT do not accept referrals for patients whose primary issues are:-

  • Schizophrenia
  • Bipolar Disorder
  • Personality Disorder
  • Anger Management
  • Obvious signs of psychosis
  • Substance Misuse (unless stable or on a treatment regime)
  • Organic Disorders of the Brain

If in doubt regarding appropriateness of referral please discuss with IAPT Team Manager or Clinical Lead.

Step 1: Menu Based Intervention

Interventions can be considered for people who may not meet the threshold for IAPT services but nevertheless may benefit from the intervention of the primary care team in the practice. Interventions which may prove useful include:-

  • Recognition of symptoms of common Mental Health problems
  • Active monitoring of symptoms
  • Psycho education
  • Sign posting examples C.A.B, Housing

Step 2: IAPT Lead Interventions (please note not all interventions available in all areas)

  • Behavioural Activation
  • Facilitated self help
  • Stress Control group
  • Depression group
  • Assertiveness group
  • Self-esteem group
  • Sleep group
  • Bereavement group
  • Anxiety management
  • Mindfulness group

A deaf Psychological Wellbeing Practitioner is also available in all localities to meet the needs of the deaf communities. The availability of the group programme is in some circumstances dependant on demand and need within the localities.

Step 3: IAPT Lead interventions (please note not all interventions available in all areas)

  • Cognitive Behavioural Therapy
  • Counselling
  • Counselling (Couples)
  • Eye Movement, Desensitisation and Reprocessing (EMDR)
  • Mindfulness
  • Cognitive Behavioural Analysis Systems of Psychotherapy (CBASP)
  • Counselling for Depression
  • Interpersonal Therapy (IPT)

Step 4/5: Specialist Mental Health Services

Access team and other specialist teams including inpatients for patients with major mental health problems requiring specialist interventions.

Referral Process

The IAPT Services accepts self-referrals, GP and other health professional referrals for patients experiencing a common mental health problem who wish to engage with a talking therapies intervention.

In Doncaster and Scunthorpe the IAPT Services are based at a Talking Shop facility and patients may self-refer by walking into the shop or telephoning. In Rotherham patients will need to telephone Nine Trees or alternatively ask their GP to make a referral.

IAPT Measures

The IAPT Services have a number of tools that are useful to measure clinical and work and social functioning outcomes.

The most common IAPT measures used are:

Patient Health Questionnaire (PHQ9) for depression on a score of 10 or above out of 27 suggest the person meets caseness and is experiencing symptoms of depression.

Generalised Anxiety Disorder Assessment (GAD7) on a score of 8 or above out of 21 suggests the person meets caseness and is experiencing symptoms of significant anxiety.